When mental health treatment such as counseling and medication are provided to clients, there frequently are other services they might to get on the path toward recovery.

Often, people need supportive services such as housing, employment assistance, peer support and crisis intervention.

Medicaid is a public health program that is funded by the federal and state governments for people who generally are lower income and have certain disabilities.

And these kinds of mental health supportive services are not typically reimbursable to a service provider by Medicaid, so the funding to pay for them has to come from elsewhere if a community wants to have this type of help available.

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Recently, Ohio-based groups The Mental Health Advocacy Coalition and The Center for Community Solutions jointly released a new study of statewide data regarding mental health supportive services that are not reimbursable by Medicaid in Ohio.

The study, "By the Numbers 2: Developing a Common Understanding for the Future of Behavioral Health Care: Analysis of Ohio's Mental Health Non-Medicaid Spending," includes an overview and specific recommendations.

Total spending on non-Medicaid services by 46 boards that participated in the study and provide mental health services was $138.3 million in 2011, the study shows.

The largest category of spending is housing and it comprises about 48 percent of the total. Crisis and employment were the second- and third-largest spending categories and combined with housing totalled two-thirds of spending.

The study recommends increased investment at both the local and state levels on supportive mental health services to ensure that every resident needing them can access them.

"The breadth of services provided across Ohio is incredibly diverse," said Tara Dolansky of The Center for Community Solutions. "However, there is a dramatic lack of consistency based on geography."

The Lake County Alcohol, Drug Addiction and Mental Health Services Board participated in the study.

ADAMHS Executive Director Kim Fraser said there is no question that the most expensive options to treat someone with a mental illness is to put them in a hospital or jail, so supportive services may help them avoid that fate.

She is proud that Lake County voters have supported funding for behavioral health care because it allows for these supportive services to be paid for and offered by ADAMHS-funded agencies. In turn, that helps people become more productive members of society.

"When you strip away Medicaid which is a very capped and very specific benefit package in the state of Ohio, when you strip that away -- the bottom line is many, many services that are provided through mental health system are not reimbursable," Fraser said. "The point of the study is that those services are absolutely critical, not only for the well-being of the individuals we serve but the community at large."

She said even when people receive psychiatric treatment, which is a reimbursable Medicaid expense for providers, if people don't have a roof over their head, food in their belly and other support, they can end up less healthy and less successful in their recovery.

"If we give people a more safe and economical option, they stay healthier in the community," Fraser said.

Spence Kline, CEO of Mentor-based Beacon Health, said employment services, support groups and other non-Medicaid funded supportive services for mental health clients in Lake County has been a large success.

When all services are pieced together, in most cases people are more successful, have a better chance to work and are a more productive citizen, Kline said.

"Our job is to help people recover to the maximum of their ability," he said. "The people who we serve want to be independent, they want to live the American Dream, have a place to live, have a car, have job, raise a family."